Indianapolis 2005

NATA/NWCA Assessor Training

Optimal Performance Calculator

Indianapolis 2005

National Athletic Trainers Annual Meeting 2005

Eileen Bowker ATCMike MoyerAlan Utter

Background

History1997 three college wrestlers died while engaged in unsafe “weight loss” activities.

Immediately the NCAA implemented sweeping rule changes. The NWCA and the NCAA Wrestling Committee worked closely with the NCAA Medical Advisory Committee to establish a gold standard weight certification program to determine the lowest allowable weight class for each wrestler.

– 1999-2000 The Optimal Performance Calculator was approved and used for all collegiate wrestling programs.

– Also during this time the NFHS Medical Advisory Committee released a “strong recommendation” that all 50 state athletic committees and high school athletic associations have a comprehensive weight management program.

2001 NWCA collaborated with the NFHS medical advisory team to establish a weight management program consisting of:

Hydration testingBody composition assessmentEstablishment of a lowest allowable weight class for each wrestlerEstablishment of a weight loss plan for each wrestlerEstablishment of a nutritional education program specific to wrestling

2004 NATA Drafts a Cooperative Agreement With the NWCA

In this agreement the NATA will develop comprehensive educational content to help coaches, wrestlers, parents, and administrators use the Optimal Performance Calculator as an effective tool to administrate the NFHS Wrestling Weight Management Program.

Components

Protocol for monitoring weight loss

Protocol for assessing hydration

Protocol for assessing body fat

Protocol for assessing weight

Implementation

Implement a co-branded program to assist state high school associations implement the new NFHS Weight Management Program in schools utilizing the Optimal Performance Calculator.

Protocols

Local/institutional testingRegional testingHuman resourceAssistance to HS athletic associations

Organizational ChartAssessors

NFHS NCAA

NWCA/NATA

Assessors

Regional Assessors

NATA CEC

Regulations

-The establishment of a minimum wrestling weight based on 7% body fat for males and 12% body fat for females.

-Hydration level of 1.025 depending on state association rules.

-Weight loss no greater than 1.5% per week of the athlete’s body weight.

Certified Athletic Trainers who belong to the NATA receive free access to the Optimal Performance Calculator to administer any state or nationally

mandated wrestling weight management program.

Establishing Minimum Weights

Weight Certification Preparation Guidelines

1. No vigorous activity on the evening before and the day of the testing.

2. Avoid any caffeinated beverages on the day before and day of the testing.

3. On the day of testing, drink 500ml (17 oz.) of fluid. (A sports drink is an excellent choice).

4. Avoid any vitamin or mineral supplements two days before and the day of testing.

5. Be awake three hours prior to testing.6. Do not eat two hours prior to testing.

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Step 1 - Assessment of Hydration Status

1. Completion of a hydration test should be required before any wrestler can undergo a body composition or weight assessment.

2. Purpose is twofold.1. Dehydration will significantly affect the

body composition measure which will result in an invalid percent body fat.

2. Dehydration or loss of water weight will directly affect minimal wrestling weight.

Step 1 - Assessment of Hydration Status

Two methods commonly used to assess urine specific gravity (Usg) are: 1) reagent test strips and 2) refractometer.

Refractometry is considered the gold standard and reagent strips are an acceptable alternative in most state associations.

The average cost of a refractometer is around $150.00-$200.00 and reagent strips average about $20.00 for a package of 100.

Step 1 - Assessment of Hydration Instruments

Refractometer Urine Test Strips

Step 1 - Assessment of Hydration Status

If a wrestler has a urine specific gravity above 1.025 (as set by the NFHS – might be 1.020 in some states), they should not be allowed to undergo the body composition assessment. If wrestler fails the hydration test they should not be assessed again for 24 hours (they are still bound to the weekly 1.5% rule when being retested).In preparation for the hydration test the athletes should be instructed to consume 2-4 cups of water in 1-2 hour period immediately preceding the test.

Step 1 - Assessment of HydrationStatus: Protocol

1) Evaluator assistant wears rubber gloves during the assessment.

2) Subject is provided a cup (marked by name or identification number). Sample should never leave the possession of the subject.

3) Subject is then instructed to provide a 2-3 oz. urine sample (mid-stream) in the urinal/bathroom under supervision.

Step #1 Assessment of Hydration Status: Protocol

4) Practice and enforce secure procedures during urine collection.

5) Urine specific gravity is then measured by reagent strips or a refractometer. (follow manufacturer's guidelines)

6) Upon successful completion of the hydration test the subject should dispose of sample and then proceed to the body weight and body composition assessment stations.

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Step 2 Assessment of Height

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Step 3 – Assessment of Body Composition

Skin calipers, bio-impedance, hydrostatic weighing, and BodPod are all currently approved by the NFHS medical advisory committee. The NCAA approves all measures except bio-impedance. Each state association has the autonomy to make the final decision.

Step 3 – Assessment of Body Composition

This measurement should ideally be taken prior to the first practice but must be performed prior to the first competition.

Step 3 - Assessment of Body Composition

Two methods commonly used to assess body fat with the critical masses are: 1) skinfold analysis and 2) bioelectrical impedance analysis (BIA).

All personnel conducting the body composition assessment should have advanced training and education in whichever method is being employed.

The average cost of skinfold calipers is around $150.00-$200.00.

Lange Skinfold Calipers

As shown below, the goal is to measure a double fold of skin and subcutaneous tissue (with sides of skinfold approximately parallel). The thicker the fat layer, the wider the fold.

Basic Rules for Taking Skinfolds• Take skinfold measurements on the right side

of the body (most skinfold equations were developed from measurements on the right side).

• Do not take measurements when the subject's skin is moist (ensure that the skin is dry, and has no lotion). Also do not take measurements immediately after exercise.

• To reduce error during the learning phase, skinfold sites should be precisely determined, marked, and verified by a trained instructor. The largest source of error in skinfold testing is inaccurate site selection.

Skinfold Rules (continued)

Firmly grasp the skinfold with the thumb and index finger of the left hand, and pull away.

Hold the caliper in the right hand, perpendicular to the skinfold and with the skinfold dial facing up and easily readable. Place the caliper heads ¼-½ inch away from the fingers holding the skinfold. Try to visualize where a true double-fold of skin thickness is, and place the caliper heads there.

Read the caliper dial to the nearest 1 millimeter within 4 seconds. During the measurement, ensure that the left thumb and forefinger maintains the shape of the skinfold.

Take a minimum of 3 measurements at each site (at least 15 seconds apart).

Skinfold Rules (continued)

Triceps SkinfoldVertical fold on posterior aspect of arm,

midway between lateral projection of acromion process and inferior margin

of olecranon process. Flex the elbow to 90 degrees to identify the landmarks.

Abdomen Skinfold SiteVertical fold, one inch to the right

side of and ½ inch below the navel.The Jackson-Pollock procedure uses a vertical fold

2 cm to the right of the umbilicus.

Subscapular SkinfoldDiagonal fold just below the

inferior angle of scapula.

Assessment of Body Composition: Bioelectrical Impedance Analysis (BIA)

A safe electrical signal is generated and passed through the wrestler being measured.

BIA measures the impedance or resistance to the electrical signal as it travels throughout the body. Resistance to the electrical signal is greater in fat mass than muscle mass, simply because fat mass is not a good conductor of electricity due to its relatively low water content.

The average cost of of a BIA machine is around $1,700.

Leg-to-Leg BIA (Tanita Corporation)

Assessment of Body Composition: Bioelectrical Impedance Analysis (BIA)

BIA does not requires a high degree of technician skill and therefore is easy to use, and provides simultaneous measurements of body weight and body composition in a short time period.

Wrestler simply stands on the scale after entering a few pieces of information (age, gender, height) and results are generated in less than 1 minute.

Body fat results are then entered into the Initial Assessment page for calculation of minimal wrestling weight.

Body Density

Skinfold Measurements

OrBio Impedance

Hydrostatic WeighingBod Pod

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Practice Lab

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Step 4 Entering the Data

Step 4 – Entering the Data

Results of the hydration, height and body weight assessment will be entered into the NWCA weight certification internet calculator on the Initial Assessment page at the NWCA website (www.nwcaonline.com).It is recommended that all assessment data for each wrestler is initially recorded on an index card so a “hard copy” backup system is available in case of data entry error.

www.nwcaonline.com

Click on Scholastic Link

Scholastic OPC Home Page

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Login Page

Assessor Code

Login Page

Entering the Data

Name, Class, etc.Urine specific gravityAlpha body weight

Step 3 Percentage of Body Fat

Step 5 Fat FreeWeight

Step 4 Fat Weight

Step 6 Minimum Wrestling Weight

Female Wrestlers

Click on the Add female wrestler link of the initial assessment page.

Only the triceps and subscapular skinfolds will be entered.

Minimal wrestling weight will be calculated at 12%.

Skinfold data then entered into the Initial Assessment form for the calculation of minimal wrestling weight.

Skinfold data

Appeal process for body composition assessment:

If the wrestler is dissatisfied with his or her body fat measurement they should be given the opportunity to appeal their results.

It is recommended that either hydrostatic weighing or air displacement (BODPOD) be used for the appeal process.

Hydrostatic Weighing for Appeal Process

Air displacement plethysmography (BOD POD) for appeal process.

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http// www.nwcaonline.com

Other forms generated by the NWCA Optimal Performance Calculator

Program

Alpha Master Report

Wrestler Access Report

Student Athlete Log In

Wrestler Nutrition Plan

Calculated Nutrition Plan

Caloric Plan

Dairy Selection

Protein Selection

Vegetables Selections

Fruits Selections

Starch Selections

Additional Selections

Individual Meal Plan

Sample Menus

Daily Assessment

It has been recommend that assessment not be conducted by the wrestling coach.

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Nutrition Education Program

Training the Coach

NWCA Basic Concepts of Weight Management and Nutritional Guidelines.Seminar to educate the coaches on healthy eating habits, safe weight loss techniques and dangers of improper weight loss.

Educating the Athlete and Parent

VideoIndividual program presentations.NWCA Web based Nutrition/Weight Management program

Healthy Training

Emphasis should be placed on training-not weight loss.Emphasis on lifelong healthy living.Consequences of dehydration.

EAT, Wrestle and WIN:A Nutritional Guide for Wrestlers

USA Wrestling NCEPSilver Level CurriculumPower Point PresentationBook

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Responsibilities for the measurement process

Individual ProgramRegional ProgramState Program

Materials

Additional Staff

On Line Computer

Body Composition

Tool

Certified Scale

RefractometerRegent Strips

CollectionCups

Data Forms

(Labels)

Site

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Implementation Models

•Regional Testing Sites•Regional Assessor Directory•“In House” Assessors

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Theory Into Practice

The New Jersey ModelRegional Testing Sites

NJ Model 2004August Memo to all NJSIAA Member

school announcing the program• Hydration info from the NJSIAA Medical

Advisory Committee• Legal opinion on weight management and

testing for hydration• Q & A on weight management• Information to assist schools in certifying scales• 2004/2005 forms• Q & A on weekly weight loss calculations• Testing Dates

New Jersey

The state was divided into 8 regions3 Sunday testing dates1 make up date

Testing Dates

October 31, 2004Regions 1 – 4 - 8

November 7, 2004Regions 2 – 5 - 7

November 21, 2004Makeup

November 14, 2004Regions 3 - 6

StaffingRegional Staffing for New Jersey Wrestling Weight Management Program

Height 3

Bathroom monitors 3

Specific Gravity 3 Tanita Scales 3 Data Entry 3

Site ManagerWelcomeStaging

Orientation

Physician

Advantages of Regional Site

Standardizes the program (less variability with assessments because fewer assessors are involved).Minimizes equipment costs because individual schools don’t have to purchase equipment.Efficient way to train apprentice assessorsCoaches will perceive it as a level playing field. Accommodates state associations that do not have certified athletic trainers in each school.

Disadvantages of Regional Site

Cost of transporting team to regional site.Logistics of reassessing a wrestler who fails the hydration test.Coordinating wrestlers, coaches, and assessors schedule with facility availability.

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Theory Into Practice

The Michigan ModelRegional Assessor

Directory

Regional Assessor Directory Logistics

State assigns master assessors to each district/section.Each master assessor trains regional apprentice assessors each fall.Master assessor compiles a regional directory of certified assessors in his/her region.Coach contacts an assessor from the directory to schedule appointment for assessor to travel to the school.

Advantages of Regional Assessor

Coaches perception of level playing field if assessors can’t assess their own teams. Individual schools do not have to purchase their own equipment (the assessors bring their own).Accommodates state associations that have a shortage of certified athletic trainers in each school.

Disadvantages of Regional Assessor

Logistics of reassessing a wrestler that fails the hydration test.Logistics of training and retraining a large pool of assessors.Variability of assessments may increase due to more assessors being involvedLogistics of maintaining an updated assessor directory.

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Theory Into Practice

The Indiana Model“In House” Assessors

“In House” Assessor Logistics

State requires each school district to train two people to perform assessments.

Assessors conduct assessments on wrestlers whenever convenient for the coach/wrestler.

Advantages of “In House” Assessors

Each school has the flexibility to conduct assessments when convenient (some wrestlers play Fall sports, may be injured during initial assessment period, etc.)

Much easier to reassess a wrestler that fails the hydration test.

Disadvantages of “In House” Assessors

Is difficult to implement in states that do not have ample number of certified athletic trainers in each school.Each school must purchase its own equipment.Logistics of training and assuring proficiencies in a large number of athletic trainers.

Current Research

NCAA weight regain studiesAverage body fat of elite wrestlersMaintenance of lean body mass

Indianapolis 2005

Panel Discussion

Thank You